Healthcare provider explaining what hormonal belly is to patient

Hormonal Belly: What it is And How To Treat It

Medically reviewed on December 19, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Whether you’re used to watching your diet or you’ve recently noticed a shift in your body shape, it’s common to think weight gain is a simple matter of “calories in, calories out.” Sometimes, however, noticing changes in specific areas like your abdomen can signify a shift in hormonal health.

Hormonal belly is a colloquial term for accumulating belly fat as the result of a unique hormonal state or underlying imbalance. This is because—no matter your physical fitness level—hormones play a key role in determining how and where weight is distributed throughout your body.[1]

At times, the hormonal explanation for developing belly fat is normal, like entering menopause. In other cases, hormonal health issues like type 2 diabetes can contribute. If you’re concerned about developing hormonal belly fat, knowing some possible causes can be a helpful first step in regaining hormonal and overall health.

Hormones and Belly Fat: What’s The Connection?

Most people consider gaining fat undesirable for well-being, but fat—also called adipose tissue—plays a vital role in human health.[2]

Apart from bumping your belt buckle up a few notches, fat underpins a variety of physical processes including [2]:

  • Storing extra energy consumed from food sources
  • Providing insulation
  • Retaining body heat
  • Cueing feelings of hunger and satiety
  • Regulating blood sugar levels and insulin sensitivity
  • Communicating with other areas of the body through hormones

On the whole, fat is a necessary part of healthy biological functioning. However, excessive amounts of certain types of body fat can cause—and sometimes mirror—underlying health conditions.[2]

Healthcare providers typically recognize two categories of adipose tissue according to where they accumulate in the body [3]:

  • Subcutaneous adipose tissue (SAT), which gathers beneath the skin all around the body.
  • Visceral adipose tissue (VAT), which surrounds the internal organs in the abdominal cavity (your belly).

Having some extra fat around your abdomen is normal. But, because fat is intimately involved in endocrine function, developing higher-than-average amounts of visceral fat may indicate a recent change or general female hormonal imbalance.[4, 5]

Why Do Women Develop “Hormonal Belly” As They Age?

The most common non-pathological reason to develop belly fat is entering the transitional reproductive phase of menopause. [6] Most women reach menopause around the age of 51, though it’s possible to reach this stage of the reproductive cycle earlier or later.[7]

Generally speaking, pre-menopausal women are more prone to gaining SAT, whereas post-menopausal women are more likely to accumulate VAT (colloquially called hormonal belly).[4,7] This shift in body shape is thought to be caused by:

  • Metabolic rate – Human metabolism tends to slow down as we get older.
  • Body composition – With age, people tend to lose muscle mass and gain adipose tissue.
  • Genetics – Genes partly determine where you gain body fat with time. If your relatives develop “hormonal belly,” there’s a chance you might, too

If you’re concerned about hormonal belly with age, some lifestyle habits may help.[9] Strength training can assist with muscle mass retention, while modestly reducing your caloric intake (by just 200 or so calories) may help buffer against overall weight gain.[9]

That said, it’s best to make any lifestyle adjustments in careful cooperation with a dietitian or other healthcare provider. They can help to ensure you create a sensible, sustainable, and nourishing diet and exercise regimen that can support your physical and hormonal well-being in the long term.

Other Reasons For Belly Fat Gain In Women

Sometimes, noticing weight gain is a simple matter of changing your exercise and nutrition habits: Eating more and moving less can contribute to belly fat in the absence of a hormonal condition.

However, if you’re a younger woman or a person assigned female at birth (AFAB) and have noticed a sudden increase in belly fat, it can help to be aware of some other explanations that could be behind the change.

Pregnancy

Though seemingly self-evident, being pregnant inevitably causes women and AFAB people to gain mass around their middle. Most women see their belly begin to swell in their second trimester.

That said, abdominal swelling may occur earlier due to hormonal fluctuations like elevated progesterone levels. Heightened progesterone can stall digestion, leading to symptoms like [10]:

  • Gas
  • Bloating
  • Slow gastric emptying (stomach emptying)
  • Acid reflux

These symptoms can result in abdominal swelling in some people, even before your “baby bump” is visible.

Hypothyroidism

Hypothyroidism is one of several conditions impacting the thyroid gland, a small but crucial organ within your endocrine system. Hypothyroidism or underactive thyroid means your thyroid gland can’t produce sufficient thyroid hormone levels (TSH) on its own.[11]

Without treatment, this can lead to [11]:

  • Feelings of fatigue and lethargy
  • A slower metabolism
  • Facial swelling
  • Muscle weakness or aching
  • Depression or low mood

In combination, many of these symptoms can result in overall weight gain.[11] It can also impact the way your body distributes the fat it stores.[11] In women and AFAB people who tend to carry extra weight around the thighs and buttocks, extra fat can appear around the midsection.

While the underlying cause of hypothyroidism isn’t always clear, it is treatable with medication.[11] After being diagnosed by a healthcare provider, many people with hypothyroidism take levothyroxine, a medicine that helps restore TSH to normal levels.[11]

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is an increasingly common hormonal disorder that impacts between 6 and 12% of women and people AFAB in the US.[12] The condition arises when an individual has high levels of androgens (male sex hormones), which can cause cysts to form on the ovaries and suspend ovulation.[13]

The connection between PCOS and weight gain isn’t yet well understood: it’s not clear whether the relationship is causal or correlative.[14] That said, PCOS has been linked to:

  • An increased tendency to store body fat, especially around the abdomen[13]
  • A higher risk of insulin resistance and type 2 diabetes, which can also lead to weight gain[13, 14]

Irregular or missed periods (amenorrhea) are hallmark symptoms of PCOS, so if your abdominal weight gain is linked with menstrual irregularities, it’s a smart idea to reach out to a healthcare provider. [14] Typically, PCOS is countered with lifestyle interventions like shedding weight and taking medications to help restore ovulation.[14]

Cushing Syndrome

People with Cushing syndrome produce elevated cortisol levels, a steroid (stress hormone) controlled by the adrenal and pituitary glands and hypothalamus.[15] Cushing syndrome can cause symptoms like [15]:

  • Abdominal weight gain and stretch marks
  • Fat between the shoulder blades
  • Facial swelling and rednessv
  • Muscle weakness
  • Diabetes

Cushing syndrome is usually brought on as a side effect of other medications.[15] It can also be caused by a tumor. While rare, an estimated 70% of people with the condition are women or AFAB people.[15]

Treatment for Cushing syndrome depends on its root cause. Following a diagnosis, your healthcare provider may recommend switching your current medication if it’s causing symptoms.[15] Cushing syndrome caused by tumors is typically treated with radiation, chemotherapy, or surgery.[15]

See related: Cortisol vs. Cortisone

Sleep Disturbances

Regularly getting adequate amounts of high-quality sleep is critical for maintaining weight and hormonal balance alike. Achieving at least 7 hours of sleep per night helps keep three major hormones related to weight in balance [16]:

  • Insulin – Sleep is crucial for regulating how your body responds to insulin. Over time, sleep debt could contribute to lowered insulin sensitivity, type 2 diabetes, and weight gain.
  • Ghrelin and leptin – These two hormones communicate your hunger and satiety cues, respectively. Sleep deficiency can raise ghrelin while lowering leptin levels, which may result in overeating and weight gain.

Getting enough sleep nightly is particularly critical in female health. In one study on short sleep duration and obesity, women and AFAB people who got less sleep were 2.49 times more likely to be overweight than other subjects.[17]

If your healthcare provider has ruled out other hormonal conditions, tuning up your sleep hygiene could support efforts at belly fat loss or weight maintenance. Sticking to a consistent sleep schedule, avoiding heavy meals before bedtime, and finding physical and mental ways to unwind can all help support better rest.[18]

Tips for Reducing Hormonal Belly In Women

It’s important to consult with a trusted healthcare provider if you’re concerned about hormones and weight loss. There may be an underlying hormone imbalance causing excess fat in the abdomen. Alongside their treatment recommendations, the following lifestyle habits can help you feel better and build a bedrock for well-being [19]:

  • Move regularly – Getting regular exercise helps fight against both VAT and SAT.
  • Eat more fiber – High-fiber foods help you feel satiated for longer. Focusing on fibrous foods may also mean you’ll be less likely to snack on highly processed options with added sugars.
  • Eat more protein – Protein is very helpful for weight loss and maintenance, particularly if you’re approaching menopause. Coupled with strength training, this can help encourage muscle mass retention as you get older.
  • Limit alcohol – Routinely drinking alcohol can lead to overall weight gain in both men and women. It’s also linked to fat accumulated specifically in the abdomen (often referred to as “beer belly”).

Finally, if you’re a frequent snacker or grazer, it’s normal to eat more than you’re aware of. Sometimes, simply jotting down the foods and beverages you eat can help you see where that extra belly fat is coming from so that you can make healthful, effective changes. Discover more hormone balancing foods in our guide.

Monitor Your Hormonal Health With Everlywell

Though “hormonal belly” is usually harmless, even small changes in your body can be an opportunity to take control of your well-being.

With Everlywell, you can investigate all facets of your hormonal health—whether you want to know your menopause status or get information about a thyroid disorder. Make a women’s online health appointment through Everlywell to speak with a licensed clinician about your concerns.

Get to know your body better by exploring the complete Everlywell Women’s Health collection today.

The Connection Between Hormones and Weight Loss

Understanding Cortisol vs. Cortisone

What Are Signs That You May Need Hormone Replacement Therapy?

References

  1. Hormones: What They Are, Function & Types. Cleveland Clinic Medical. Last reviewed February 22, 2022. URL. Accessed December 11, 2023.
  2. Adipose Tissue (Body Fat): Anatomy & Function. Cleveland Clinic Medical. Last reviewed August 15, 2022. URL. Accessed December 11, 2023.
  3. Body Fat. The Nutrition Source, 2 Feb. 2023. Last reviewed August 2022. URL. Accessed 11 Dec. 2023.
  4. Mittal, Balraj. Subcutaneous Adipose Tissue & Visceral Adipose Tissue. The Indian Journal of Medical Research, U.S. National Library of Medicine, May 2019. URL. Accessed 11 Dec. 2023.
  5. Visceral Fat: What It Is & How to Get Rid of It. Cleveland Clinic Medical. Last reviewed September 12, 2022. URL. Accessed December 11, 2023.
  6. 4 Doctor-Approved Ways Women Can Fight Belly Fat. Mayo Clinic. June 28, 2023. URL. Accessed December 11, 2023
  7. Premature & Early Menopause: Causes, Symptoms & Treatment. Cleveland Clinic Medical. Last reviewed September 6, 2022. URL. Accessed December 11, 2023.
  8. Numao, Shigeharu, et al. Association of Abdominal Fat with Metabolic Syndrome Components in Overweight Women: Effect of Menopausal Status. Journal of Physiological Anthropology, U.S. National Library of Medicine, 19 Apr. 2020, URL. Accessed December 11, 2023.
  9. The Reality of Menopause Weight Gain. Mayo Clinic. Mayo Foundation for Medical Education and Research. July 8 2023. URL. Accessed 11 Dec. 2023.
  10. P;, Coquoz A;Regli D;Stute. Impact of Progesterone on the Gastrointestinal Tract: A Comprehensive Literature Review. Climacteric : The Journal of the International Menopause Society, U.S. National Library of Medicine, URL. Accessed 11 Dec. 2023.
  11. Hypothyroidism (Underactive Thyroid). Mayo Foundation for Medical Education and Research, 10 Dec. 2022, URL. Accessed December 11, 2023.
  12. Deswal, Ritu, et al. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of Human Reproductive Sciences, U.S. National Library of Medicine, 2020, URL. Accessed 11 Dec. 2023.
  13. Polycystic Ovary Syndrome (PCOS). Johns Hopkins Medicine, 28 Feb. 2022, URL. Accessed December 11, 2023.
  14. PCOS (Polycystic Ovary Syndrome) and Diabetes. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Last reviewed December 30, 2022 URL. Accessed December 11, 2023.
  15. Cushing Syndrome: Causes, Symptoms & Treatment. Cleveland Clinic Medical. Last reviewed December 27, 2022. URL. Accessed 11 Dec. 2023.
  16. How Sleep Affects Your Health. National Heart Lung and Blood Institute, U.S. Department of Health and Human Services,. Last updated June 15, 2022. URL. Accessed December 11, 2023.
  17. Li, Qing. The Association between Sleep Duration and Excess Body Weight of the American Adult Population: A Cross-Sectional Study of the National Health and Nutrition Examination Survey 2015–2016 - BMC Public Health. BioMed Central, BioMed Central. February 11, 2021. URL. Accessed December 11, 2023.
  18. 6 Steps to Better Sleep. Mayo Foundation for Medical Education and Research. May 7, 2022. URL. Accessed December 11, 2023.
  19. 10 Ways to Get Rid of Belly Fat for Good. Cleveland Clinic, 4 Dec. 2023. URL. Accessed December 11, 2023.
Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.
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